Provider Demographics
NPI:1447285937
Name:SYNERGY HEALTHCARE, INC
Entity type:Organization
Organization Name:SYNERGY HEALTHCARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBICHAUX
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:985-532-9140
Mailing Address - Street 1:616 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:LA
Mailing Address - Zip Code:70374-2735
Mailing Address - Country:US
Mailing Address - Phone:985-532-9140
Mailing Address - Fax:985-532-9205
Practice Address - Street 1:616 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:LA
Practice Address - Zip Code:70374-2735
Practice Address - Country:US
Practice Address - Phone:985-532-9140
Practice Address - Fax:985-532-9205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4332IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1267376Medicaid
LA1929097OtherNCPDP #
LABT6516833OtherDEA #